How To Use CPT Code 93355

CPT 93355 describes the use of transesophageal echocardiography (TEE) for guidance during transcatheter intracardiac or great vessel structural interventions. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93355?

CPT 93355 is used to describe the use of transesophageal echocardiography (TEE) for guidance during transcatheter intracardiac or great vessel structural interventions. This code is specifically used when real-time image acquisition and documentation, guidance with quantitative measurements, probe manipulation, interpretation, and report are performed during the procedure. It may also include the administration of ultrasound contrast, Doppler, color flow, and 3D imaging.

2. Official Description

The official description of CPT code 93355 is: ‘Echocardiography, transesophageal (TEE) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, TAVR, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial appendage occlusion/closure, ventricular septal defect closure) (peri-and intra-procedural), real-time image acquisition and documentation, guidance with quantitative measurements, probe manipulation, interpretation, and report, including diagnostic transesophageal echocardiography and, when performed, administration of ultrasound contrast, Doppler, color flow, and 3D.’

3. Procedure

1. The provider prepares the patient for the procedure, ensuring appropriate anesthesia and patient positioning.
2. An ultrasound transducer is inserted through an endoscope into the esophagus to obtain images of the heart’s valves, chambers, and great vessels.
3. The provider uses these images to guide a catheter into the heart or great vessels and perform various structural interventions, such as transcatheter valve replacements, mitral valve repairs, closure of ventricular septal defects, or left atrial appendage occlusion.
4. During the procedure, the provider acquires real-time images, manipulates the probe to obtain different views, performs quantitative measurements, and interprets the findings.
5. If necessary, the provider may also administer ultrasound contrast, perform Doppler and color flow imaging, and utilize 3D imaging techniques.
6. After the procedure, the provider documents the findings, interpretations, and any additional recommendations in a report.

4. Qualifying circumstances

CPT 93355 is used when transesophageal echocardiography (TEE) is performed to guide transcatheter intracardiac or great vessel structural interventions. These interventions may include procedures such as transcatheter aortic valve replacement (TAVR), transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial appendage occlusion/closure, or ventricular septal defect closure. The use of TEE provides real-time imaging and guidance during these procedures, allowing for accurate placement of catheters and optimal outcomes.

5. When to use CPT code 93355

CPT code 93355 should be used when transesophageal echocardiography (TEE) is performed during transcatheter intracardiac or great vessel structural interventions. It is important to note that this code should not be reported in conjunction with codes 76376, 76377, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93320, 93321, or 93325.

6. Documentation requirements

To support a claim for CPT 93355, the provider must document the following information:

• Indication for the procedure and the specific transcatheter intracardiac or great vessel structural intervention being performed
• Details of the transesophageal echocardiography (TEE) procedure, including the use of real-time image acquisition, guidance with quantitative measurements, probe manipulation, and interpretation
• Documentation of any additional procedures performed during the intervention, such as transcatheter valve replacements or repairs
• Findings, interpretations, and any recommendations made by the provider
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 93355, ensure that the procedure meets the criteria for transcatheter intracardiac or great vessel structural interventions and that transesophageal echocardiography (TEE) was used for guidance. It is important to note that CPT code 93355 should not be reported with codes 76376, 76377, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93320, 93321, or 93325.

8. Historical information

CPT code 93355 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes transcatheter aortic valve replacement (TAVR) with the guidance of transesophageal echocardiography (TEE) to ensure accurate placement of the new valve.
2. A provider performs a transcatheter pulmonary valve replacement, utilizing transesophageal echocardiography (TEE) for real-time imaging and guidance during the procedure.